Organization Active NPI

Gary Kimmel MD PC

  • Plastic Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1962678771
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
214093 Issued in NY
Legal business name
GARY KIMMEL MD PC
Practice address
112 Prospect Park W
Brooklyn, NY 11215-3710
Phone
(718) 832-9488
Fax
(718) 369-1753
NPI assigned
May 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gary Kimmel, M.D.
Title
President
Phone
(718) 832-9488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 214093 NY Primary

Addresses

Primary practice location

112 Prospect Park W
Brooklyn, NY 11215-3710

Mailing address

112 Prospect Park W
Brooklyn, NY 11215-3710
Phone (718) 832-9488

Other identifiers 1

IdentifierTypeStateIssuer
02310525MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1962678771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 PROSPECT PARK W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153710",
            "telephone_number": "718-832-9488",
            "fax_number": "718-369-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PROSPECT PARK W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153710",
            "telephone_number": "718-832-9488",
            "fax_number": "718-369-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY KIMMEL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-832-9488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "214093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02310525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.